Finding What Preventive Treatments Work Unintentionally

Within the journey to manage ongoing (chronic) migraine, sometimes unexpected discoveries occur. I had one such discovery when my normal regimen of migraine preventive medicines was unintentionally paused due to an illness. This interruption revealed important data about drug effectiveness that would have otherwise been missed.

What preventive migraine treatments do I use?

Of the medicines I take to prevent my chronic migraine, one is a once-a-month calcitonin gene-related peptide (CGRP) injection. The others are nightly pills. These preventive drugs include:

• Aimovig^® (erenumab)
• Topamax^® (topiramate)
• Gabapentin

I have been taking gabapentin the longest, but not strictly for migraines. The gabapentin was supposed to help my migraine and my neuropathy. The next drug I started was Topamax. Finally, I started using Aimovig injections.

Did my viral infection respond to my nausea drug?

A couple of months ago, I ended up with a viral infection. It was a version of one that seemed to be going around my community at the time. In addition to my migraine-related nausea, this viral infection made my nausea even worse. So much so that I could not keep anything down at all.

I am lucky that my Zofran^® is not a pill but a dissolvable tablet. Despite multiple doses a day of the nausea drug, I still could not hold anything down. So I could not take my oral medicines.

How did my body react?

Since I could not keep my oral medicines down, I came off all of them the hard way. The appropriate way to stop taking medicine is to slowly decrease the dose until you are off. This is called tapering. Stopping medicines cold turkey is not suggested or medically approved.

When you abruptly discontinue a medicine, you may experience withdrawal. Withdrawal occurs when your body struggles to cope in the absence of a substance to which it is accustomed.¹

Since I was so ill from the viral infection that I caught, I could not honestly tell which symptoms were from the viral infection and which were from withdrawal. Some of the symptoms that could easily have been from either were:

• Body aches
• Nausea
• Vomiting

What did I realize in this experience?

One takeaway I had in this case was how little effect the oral drugs I was taking had on my chronic migraine. It is so easy to simply continue adding medicines to our preventive drug regimen. It is less common to have a doctor choose to take us off drugs that have not been effective. Sometimes we have to bring this topic up with our doctors during appointments.

In conclusion, this accidental discovery of what preventive treatments work has been a pivotal moment in the ongoing journey of managing my chronic migraine. This experience made it clear that not all treatments are equally effective.

Engaging in open, honest conversations with healthcare providers about this topic is important for refining treatment plans and being proactive in managing migraines. Remember – what works for me may not work for you.